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Septic Thromboemboli
Joseph Junewick, MD FACR
over 4 years ago
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UVC Related Hepatic Injury

Case Detail

Anatomy: Gastrointestinal
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Trauma
Created: over 5 years ago
Updated: over 5 years ago
Tags: PEDS
Modality/Study Types: US
Activities:
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History

Premature newborn with low hemoglobin.


Case Images


Diagnosis

Hepatic injury with hemoperitoneum secondary to umbilical venous catheter

Clinical Notes

The patient was transferred from another institution with the history of an umbilical venous catheter projected over the right lobe of the liver on radiography.

Findings

US – Irregular hypovascular regions of decreased echogenicity in the liver with echogenic ascites.

Discussion

Umbilical venous catheters are important to administer TPN, medication, and intravenous fluid, to perform exchange transfusions and to monitor central venous pressure. Complications related to umbilical catheterization include vascular injury, hepatic necrosis, infection, thrombosis, and portal hypertension.

The umbilical vein drains to the left portal vein, then to the ductus venosus, then to the left hepatic vein or IVC. Ideally the tip of the UVC catheter should be at the junction of the IVC and the right atrium.

Complications may be related to numerous factors. The pH, tonicity or chemical nature of the infusiates may cause endothelial irritation. The tip of the catheter may penetrate during initial placement or erode after prolonged duration of use.

Reference

Lim-Dunham JE et al. Characteristic Sonographic Findings of Hepatic Erosion by Umbilical Vein Catheters. J Ultrasound Med 2007; 26:661-666.



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